Abstract

It is well known that good surgical technique alone does not prevent adhesion formation (Table 1). 11,46,56,71,75 Indeed, adhesions are a major cause of failed surgical therapy, account for a wide range of clinical symptoms from abdominal complaints to intestinal obstruction, and make repeated surgery time consuming and hazardous. 10 The problem of postsurgical adhesions to health care delivery increases with the patient's age, the number of laparotomies, and the complexity of operative procedures. 65 Widespread concerns about the morbidity associated with adhesions and about health care costs are shared by federal and state governments as well as private insurers. 16,46 In 1988, the economic burden of hospitalization for lower abdominal–pelvic adhesiolysis in the United States, including hospital costs ($254.9 million) and surgeons' fees ($925 million), was estimated at $1179.9 million. 60 Inclusion of outpatient medical costs (including the value of lost worker output) would substantially increase the economic burden of abdominal adhesive disease.

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